Which of the following assessment data is relevant for clients diagnosed with Glaucoma?

SCTIMST Staff Nurse - 2015 (Set-A)

Medical & Surgical Nursing

Easy

Appeared in: SCTIMST Staff Nurse - 2015 (Set-A)

Explanation

A history of diabetes mellitus is a significant risk factor for developing glaucoma.
Diabetes can cause changes in the small blood vessels (microvascular damage) throughout the body, including those that supply the optic nerve.
This impaired circulation makes the optic nerve more vulnerable to damage from the increased intraocular pressure (IOP) characteristic of glaucoma.
Therefore, assessing for a history of diabetes is a crucial part of the nursing assessment for a client with glaucoma.

Option B: While some sources list migraine syndromes as a risk factor for glaucoma, the association is generally considered less strong and direct than that of diabetes. For a general nursing assessment, diabetes is a more critical and universally recognized risk factor.
Option C: There is no established clinical evidence linking a history of chronic sinusitis to an increased risk for or complications with primary glaucoma.
Option D: A history of bronchial asthma is not a risk factor for developing glaucoma. However, it is a critical piece of information for managing a patient with glaucoma. Beta-blocker eye drops (e.g., Timolol), a common treatment, are contraindicated in patients with asthma because they can cause life-threatening bronchospasm. The question asks for relevant data, and while this is relevant for treatment, diabetes is relevant to the disease risk itself.

Clinical Relevance

Nursing practice connection: Use the key finding related to Risk factors and relevant comorbidities for glaucoma to guide bedside assessment, documentation, and the next nursing action.
A nurse's primary role includes taking a thorough health history to identify risk factors and contraindications for treatment. For a glaucoma patient, this is essential for both long-term management and immediate safety.
Failure to ask about a history of asthma before administering beta-blocker eye drops can lead to a severe adverse reaction (bronchospasm), which is a critical patient safety issue.
What if? If a patient with glaucoma and a history of asthma presents with uncontrolled IOP, the nurse should anticipate the provider will prescribe a non-beta-blocker medication, such as a prostaglandin analog (e.g., latanoprost) or a carbonic anhydrase inhibitor.

How to Approach the Question

First, analyze the question: It asks for assessment data that is 'relevant' for a client diagnosed with glaucoma.
Understand that 'relevant' can mean a risk factor for the disease, a factor affecting its progression, or a condition impacting its treatment.
Evaluate each option. Recall or look up the known risk factors for glaucoma. Diabetes is a well-established risk factor.
Consider the other options. Asthma is not a risk factor for getting glaucoma, but it is a major contraindication for a common treatment (beta-blockers). This makes it highly relevant for patient safety.
Differentiate between a risk factor for the disease (Diabetes) and a contraindication for treatment (Asthma). Often, questions about 'relevant data' for a diagnosis point towards risk factors. Diabetes is more directly related to the pathophysiology and risk of the disease itself.
Select the option that represents the most direct and established link to the disease process, which in this case is the history of Diabetes Mellitus.

Concept Tested & Keywords

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E6 Nursing Brunner Adult Health 3SA Vol 2 Part 1 pp. 96-98, 94-96

E6 Nursing Fundamentals Potter Perry 12e Part 3 p. 78-80